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HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: April 30th 2020 Permit Number: I J - • Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: Reroof PROPOSED IMPROVEMENT LOCATION: Building Permit Application Commercial Residential x Address: 99 S Las Olas Drive Jensen Beach Florida 34990 Property Tax ID #: 4511-500-0036-000-7 Site Plan Name: Project Name: Walter Reroof Lot No. Block No. DETAILED DESCRIPTION OF WORK: I Remove existing roofing system and install new shingle roofing system Ow6nS Corv6^1 Shim3l0-1 FLIOWT4) Tri &I11� Sand (F I&o46. 1) +OyHKI &11 Vey+7-8417.2-) CONSTRUCTION INFORMATION: Additional work to be performed under this permit– check all that apply: _Mechanical _ Gas Tank — Gas Piping — Shutters _ Electric _ Plumbing Total Sq. Ft of Construction: 1300 Cost of Construction: $ 7000.00 _ Sprinklers _ Generator Sq. Ft. of First Floor: Utilities: —Sewer _Septic Windows/Doors c7 -Roof 3 ! 2 Pitch Building Height: 10 OWNER/LESSEE: CONTRACTOR: NameJane C Walter Name: Dee Keihn Address: 99 S Las Olas Drive Company:Pdk Roofing Inc City: Jensen Beach State: _ Zip Code: 34990 Fax: Phone No. 7729192978 Address: 1299 Sw Biltmore Street City: Port St Lucie State: FL Zip Code: 34983 Fax: Phone N0771-528-0113 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail pdkroofing.inc@gmail.com State or County Licenseccc1331408 it value or construction is,525v0 or more, a RECORDED (Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name; Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City; City: Zip: Phone: Zip; Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting apermit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Assoc sso cation rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply, In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEEMMJENT PT,ST41�11) ON THE H (WR ENDER,$AAlyl'ATRE T09N Y B FIRST INSPECTIO ORE RECORDING I YOU0ICE 4 CO;A E RESULT IN YOUR PAYING NVIST BERREE NO ki CING, CONSULT nev. /_/ /I i7 ti n ure of Owner/ Le s e/Contractor Ag t for Owner ign re of Contrac r/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF L.t-kct_ e- COUNTY OF Q�_ The orgoing instrurpent.was acknowledged before me The forgoing instrurrient was acknowledged before me this day of ft ll, 2Q,-)Ct by this day of , 2fl0�) by Name of person making statement. Name of person making statement. Personally Known �,�OR Produced Identification Personally Known �—OR Produced Identification Type of Identification Type of Identification Produced Produced (Signa re of Notary Public- Staof Flo ' a) (Signatu e of Notary Public- Stat of FQMaj Commission No. ALE? AGUIRRE ER IRRE Commission No. i+ii1 CCI�GG234811 R MY COkt1KWION # GG 234811 o EXPIRES;: July 4, 2022 e REVIEWS ¢; FE PLANS VEGETA I N SEA TURTLE MANGROVE COLTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED nev. /_/ /I i7